The evolution and ethical implication of the Physician’s Pledge: A guide for medical practitioners

Abstract

Healthcare started as a one-man business where only the doctor received, reviewed, diagnosed, prescribed, dispensed the treatment, and nursed the patient. There was no regulation, and hence society relied solely on the doctor's morals for appropriate treatment, professional handling of patients, and confidentiality. The doctor was highly regarded in society and was close to royalty. The perceived benefits and lack of external regulation bred charlatans and eroded society's confidence stimulating the development of the Hippocratic Oath. The Hippocratic Oath has progressively evolved in tandem with developments in society to what it is today. From the Hippocratic Oath, medical ethics sprung and evolved. We review several oaths that abound in medical practice and their evolution over the years to what we have today as the Physician’s Pledge. We reviewed several articles published in English within ten years based on specified search terms for conformity. The selected articles were screened for relevance to the research topic, and necessary data were extracted. The Oath, though controversial in origin, evolved from a one-liner “primus non nocere” to what it is today, having started as a document heavily influenced by religion to become completely secular. It also transitioned from relying on the physician's morality for compliance to becoming externally enforceable. The transformations of the Oath and Ethics, which could be seen as the compartmentalization of the Oath based on this study, resulted from landmark events in society and changes in religious ideologies and societal morals. The existence of many forms of the Oath was also established. Some of the Oaths were also adapted to suit the morals and beliefs of the areas used. In conclusion, concluded that the “One Oath for All” era is over. We propose an Oath or Pledge that will suit our society to avoid going counter to our laws.